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The effect of combined mouth wash Gentamycine, Colistin and Vancomycine in prevention of Ventilator Associated Pneumonia in mechanical ventilatory patients admitted to intensive care unit: A randomized Clinical Trial
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Naser Gharebaghi1    , Mohammad amin Valizade hasanloei 2, Arash Mosarrezaii3 , Sima Mohseni rad4 |
1- of infectious disease, Urmia University of Medical Sciences, Urmia, Iran
2- Urmia University of Medical Sciences,Urmia, Iran. , aminvalizade@yahoo.com
3- Urmia University o Medical Sciences, Urmia, Iran
4- Urmia University of Medical Sciences, Urmia, Iran |
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Abstract: (3301 Views) |
Background and Aim: Ventilator-acquired pneumonia is common in invasive mechanical ventilatory patients. There are various methods to prevent and reduce the incidence of ventilator-acquired pneumonia, one of which is the use of combined mouthwashes. The purpose of this study was to evaluate the effect of combined mouthwash on the prevention of ventilator-acquired pneumonia.
Materials and Methods: In this clinical-trial study, patients were randomly selected and divided into control and study group. The patients with GCS = 3 and brain death and mechanical ventilation less than 48 hours were excluded from the study. The control group received 0.2% chlorhexidine for mouthwash and the study group received gentamicin 2%, colistin 2% and vancomycin 2%. Mouthwashes were used until the creation of pneumonia symptoms, patient mortality, and endotracheal intubation. Statistical analysis was completed after the study.
Results: The incidence of pneumonia was 19 (30.64%) in the study group and 16 (25.8%) in the control group (P = 0.23). In the study group, 39 (62/9%) patients and in the control group 40 patients (64/5%) were discharged (P = 49/0). Cultures endotracheal secretions were reported negatively in 40 patients (5.64%) of study group and 45 patients (58.72%) in control group (P = 0.04). The isolated bacteria in the study group included 11 cases of Acinetobacter (50%), four cases of Pseudomonas (18.18%), two cases of E.coli (9.09%), two cases of Klebsiella (9.09%) and three cases of Gram -positive (16.63%). Also these bacteria were reported as 11 cases of Acinetobacter (64.7%), three cases of Klebsiella (17/64%), two cases of Pseudomonas (11.76%), one case of E.coli (5.9%) in control group (P = 0.001).
Conclusion: This study showed that a mouthwash with a combination of Gentamicin-Clestin and Vancomycin, compared to chlorhexidine, was not more effective in preventing ventilator-associated pneumonia in patients undergoing mechanical ventilation.
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| Keywords: Ventilator-Acquired Pneumonia, Combined Mouthwash, Chlorhexidine, Intensive Care Unit |
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Full-Text [PDF 588 kb]
(727 Downloads)
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Type of Study: Applicable |
Subject:
General
Received: 2018/12/5 | Accepted: 2019/10/8 | Published: 2020/03/29
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